闭合复位近端防旋内钉对老年股骨粗隆骨折患者并发症及恢复效果的影响

The Effect of Closed Reduction Proximal Femoral Nail Antirotation on the Complications and Recovery Effect in Elderly Patients with Femoral Peritrochanteric Fracture

目的:探讨闭合复位近端防旋内钉(PFNA)对老年股骨粗隆骨折(FPF)患者并发症及恢复效果的影响。方法:选取2013年5月-2017年12月本院收治的老年FPF患者178例,依据治疗方法分为PFNA组和置换组,每组各89例,PFNA组给予闭合复位PFNA术治疗,置换组给予髋关节置换术治疗。结果:相较于置换组的切口长度、住院时间、并发症发生率、术中出血量、术后引流量,PFNA组均明显较低,比较差异均有统计学意义(P<0.05)。相较于术前,两组Harris评分明显较高(P<0.05),PFNA组和置换组术后Harris评分和关节功能优良率基本相同,差异无统计学意义(P>0.05)。结论:与髋关节置换术比较,闭合复位PFNA术治疗老年FPF也具有良好的治疗疗效,能够实现对患者并发症及手术创伤发生的有效减少,便于患者的身体恢复,值得临床做进一步推广。

Objective:To investigate the effect of closed reduction of proximal anti-rotation internal nail(PFNA)on complications and recovery of elderly patients with femoral trochanteric fracture(FPF).Method:178 elderly FPF patients admitted to our hospital from May 2013 to December 2017 were divided into PFNA group and replacement group according to the treatment method,89 cases in each group.The PFNA group was treated with closed reduction PFNA,the replacement group was given hip replacement.Result:Compared with the incision length,hospital stay,complication rate,intraoperative blood loss and postoperative drainage in the replacement group,the PFNA group were significantly lower,the difference was significant(P<0.05).Compared with the preoperative,Harris score was significantly higher in the PFNA and replacement group at postoperative(P<0.05),and the postoperative Harris score and joint function were basically the same in the PFNA group and the replacement group,with no statistical difference(P>0.05).Conclusion:Compared with hip replacement,closed reduction PFNA has a good therapeutic effect on elderly FPF,which can effectively reduce the complications and surgical trauma of patients and facilitate the recovery of patients.It is worthy of further promotion in clinical practice.